Request for Placement Approval

PSYC 491, Field Experience in Psychology

Use this form to request approval of a placement that is not in the list of available sites for PSYC 491. Submit this form to Ms. Stephanie McWilliams by placing it in her mailbox in the Psychology Department main office (room 1124 LSB) or by sending the information requested below in an e-mail message to: srmcwilliams@mail.wvu.edu

Your Name

Your Name FirstLast

WVU Mix Email

Name of organization:

Location of organization:

Brief description of the goals of the organization:

Brief description of the activities you would engage in during this placement: